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The Varying Permeability Model By Dan ReindersPowerPoint Presentation

The Varying Permeability Model By Dan Reinders

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### The Varying Permeability ModelBy Dan Reinders

An easy explanation for the

mathematically disinclined

First an Introduction to bubbles:

- The pressure of gas in a bubble is equal to the surrounding hydrostatic pressure plus a contribution from surface tension.
- The contribution from surface tension is found by the following formula: P(surface tension) = 2/radius
- A bubble about the size of a red blood cell (4 um radius) has its pressure raised by up to 0.5 atmospheres.

Gas diffuses from bubbles

- If the pressure inside a bubble is greater than the pressure of the DISSOLVED gas in the surrounding tissue, the bubble will shrink.
- Conversely if the pressure in the bubble is less than the tissue dissolved gas pressure the bubble will grow.

- Except for after decompression, this means that all bubbles should eventually dissolve - surface tension makes the bubble pressure higher than the surrounding dissolved gas pressure.
- This is especially true for divers, since the dissolved gas pressure is lower than the ambient pressure due to oxygen metabolism.
- In reality, bubbles don’t always dissolve.

Enter the Varying Permeability Model! should eventually dissolve - surface tension makes the bubble pressure higher than the surrounding dissolved gas pressure.

- To explain why bubbles don’t always dissolve, a lot of ideas have been suggested.
- The best explanation so far is that the tiny bubbles become stabilised by “surface active molecules”
- These are molecules that embed themselves in the gas-water interface.

How do “surfactants” stabilise bubbles? should eventually dissolve - surface tension makes the bubble pressure higher than the surrounding dissolved gas pressure.

- Just as each water molecule “pulls” towards each-other in surface tension, each surface active molecule “pushes” against the others.
- This counteracts the effect of surface tension, and therefore eliminates the loss of gas by diffusion.
- No diffusion means no bubble dissolution.

Surfactants can be thought of as tiny springs pushing against each-other at the interface.

What happens during crushing? against each-other at the interface.

- When a bubble is compressed by descending, the area available for each spring lowers. Basically each spring pushes back more as it bumps against it’s neighbours.
- But just like real springs, eventually it can’t push back any more - it runs out of travel.
- At this point springs will start popping off the bubble surface.

- More precisely, it becomes energetically favorable for a spring to leave the surface rather than to compress further.
- The effect of surface tension is now countered and the bubble stabilises at its new smaller radius.

Growing Bubbles spring to leave the surface rather than to compress further.

- Recall that bubbles grow when the dissolved gas pressure is greater than the interior bubble pressure.
- This means that small bubbles require a greater “super-saturation” in order to be stimulated into growth.
- Therefore crushed nuclei are better for divers than uncrushed nuclei.

Wait a second - didn’t you just say that the surface tension was negated in the crushed nuclei?

- This would mean that big bubbles would grow as easily as small bubbles.
- But this doesn’t happen.
- At first the bubble expands, but then the springs “lose contact” with each-other.
- Then they can’t push against each-other and surface tension reigns supreme.

Do surfactant’s have any other effects? tension was negated in the crushed nuclei?

- Yes - they form a barrier to diffusion.
- The closer they are squeezed together, the stronger the barrier to diffusion.

Kunkle vs. Yount tension was negated in the crushed nuclei?

- There are two main bubble surfactant models out there:
- One by Dr. Thomas Kunkle
- One by Dr. Yount

Kunkle’s model tension was negated in the crushed nuclei?

- Assumes that when surfactants leave the bubble they don’t return or interact in any way.
- Fully accounts for the “springiness” of the springs.
- The diffusion barrier strength depends on the space available for each surfactant.

Yount’s Model tension was negated in the crushed nuclei?

- Assumes that there is a reservoir of surfactants “hanging around” just outside the bubble.
- Accounts for the transfer of surfactant molecules between the reservoir and the bubble surface.
- Uses “unspringy springs”, the springs either don’t push back or else push back at their “popping-off” threshold. They act more like billiard balls than springs.

What’s the deal with “Varying Permeability”? tension was negated in the crushed nuclei?

- The surfactants either don’t form a diffusion barrier, or completely block diffusion.
- This “impermeability” occurs after about 300 fsw of compression, so is not really a concern for most divers.
- An impermeable bubble won’t be crushed as much as a permeable bubble because gas doesn’t diffuse out as it shrinks.

The Reservoir tension was negated in the crushed nuclei?

- The VPM also accounts for an electrostatic force between the reservoir and the surface.

The Electrostatic Forces tension was negated in the crushed nuclei?

- “B” is the sum of various electrical and chemical attractions and repulsions.
- The pressure balance equation is: Pbubble + 2c/radius - B = Ambient Pressure + 2/radius
- c accounts for the springy “push back” effect of the surfactants.

What we need to know about bubble crushing. tension was negated in the crushed nuclei?

- We assume that the gas pressure in the bubble is equal to the outside tissue pressure - aka diffusive equilibrium.
- Ignoring oxygen effects, this means that Pbubble is equal to the ambient pressure since the ambient pressure would equal the tissue pressure.

- Using the pressure equation: before crushing: Ptis + 2 tension was negated in the crushed nuclei?c/ro - B0 = Psurface+ 2/ro after crushing: Ptis + 2c/rcrush - Bc=Pdepth+ 2/rcrush
- Where Ptis is the tissue gas pressure (assumed equal to Psurface), ro is the initial radius and r crush is the final radius.
- Setting B0 equal to Bc gives us the equation for the crushed radius

The CRUSHING formula: tension was negated in the crushed nuclei?

Pcrush = Pdepth - Ptis

CF = Crush factor = 2 (c - )

Rcrush = 1/((Pcrush/CF) + 1/ro)

The Meta-Stable state tension was negated in the crushed nuclei?

- A different “B” value is used as the tissue saturates, to represent the nuclei forming a semi-stable state.
- The nuclei is exponentially restored to it’s original size as surfactants return from the reservoir to the interface.
- This process occurs over many days, but may occur faster in living organisms.

Decompression and Nuclei tension was negated in the crushed nuclei?

- Even a bubble not stimulated to growth will expand with a drop in pressure.
- The same equations are used: During saturation: Ptis + 2c/rs - Bs = Pdepth+ 2/rs after decompression: Ptis + 2c/rd - Bd=Psurface+ 2/rd
- d subscript refers to decompression, s refers to saturation

Bubble Growth tension was negated in the crushed nuclei?

- Bubbles grow when the super-saturation pressure is greater than 2/r (surface tension).
- Note that nuclei growth during decompression makes the nuclei easier to turn into a full-fledged bubble.
- All of the previous equations can be combined to find the smallest bubble stimulated into growth.

Bubble Numbers: tension was negated in the crushed nuclei?

- The VPM predicts that there is an exponential distribution of nuclei - lots of small ones and a few big ones.
- The number of nuclei stimulated into growth is related to the minimum size stimulated into growth by the following equation:
- Nstimulated = Ntotal (e - K * Rstimulated )

Take Home Messages tension was negated in the crushed nuclei?

- Greater super-saturation stimulates more bubbles into growth
- Greater crushing pressures help minimise the number of stimulated bubbles
- Saturation decompressions must be more conservative to allow for the loss of the crushing effects.

VPM and dive tables tension was negated in the crushed nuclei?

- There is a lot of confusion about how the VPM is integrated in dive models.
- The concept is actually quite simple, but this simplicity is somewhat hidden by the elegant procedures used to generate the dive tables.

Minimum Bubble Number tension was negated in the crushed nuclei?

- The VPM assumes that there is a minimum bubble number (regardless of bubble size) that can be tolerated without decompression sickness.
- IF this is true, then keeping the super-saturation's below that required to stimulate the critical number of nuclei should prevent decompression sickness.

- This assumption works great for saturation exposures, but is too conservative for normal (no-deco/mild deco) dives.
- Solution - assume that there is a maximum volume of gas that is allowed, ONLY counting nuclei from below a critical radius

Half-times and bubble growth too conservative for normal (no-deco/mild deco) dives.

- “Fast tissues” remove inert gas faster than slow tissues, meaning that bubbles don’t have time to grow as big as they do in slow tissues.
- Initially the bubbles grow faster because of the typically higher pressure difference, but this is greatly outweighed by the quick removal of source gas.

Many small or few big too conservative for normal (no-deco/mild deco) dives.

- This means fast tissues can have lots of small bubbles, while slow tissues can have hardly any bubbles above the minimum number.
- A Greater super-saturation is allowed for fast tissues.

Increasing Gradients too conservative for normal (no-deco/mild deco) dives.

- The VPM starts out by just stimulating the minimum safe number of bubbles.
- The maximum allowed super-saturation is then increased, and the volume of excess gas in each compartment is compared to the maximum permitted.
- If it is less than allowed, the super-saturation is increased again and again, until the compartment maximum is reached.

Does the VPM apply? too conservative for normal (no-deco/mild deco) dives.

- It certainly has shown that it can be used to generate successful dive tables.
- It has some support from human and animal data.
- It has apparently been successful during data fitting by Dr. Wienke with the new Reduced Gradient Bubble Model.

Other candidate models too conservative for normal (no-deco/mild deco) dives.

- Many of the successes of the VPM (deeper predicted decompression stops, etc) can also be explained by models of diffusive bubble growth and “phase equilibrium” models (where there is an excess of available nuclei for the gas to grow into bubbles).
- Impossible at present to tell which model is correct, so best to reserve judgement.

Other ways to stabilise nuclei too conservative for normal (no-deco/mild deco) dives.

- Hydrophobic crevices can also form nuclei (you see this in your beer glass).
- Nuclei may also be continually created by friction in your joints and muscles and by cavitation in your heart valves. The magnitude of these effects may turn out to be more important than crushing and regeneration effects.

Bottom line too conservative for normal (no-deco/mild deco) dives.

- Both phase equilibrium, diffusive bubble growth and VPM models have been used to successfully generate dive tables.
- All of these models make suggestions of the same nature (deeper stops and lower super-saturation’s), so we don’t really have a way to discriminate amongst them.

Conclusion too conservative for normal (no-deco/mild deco) dives.

- VPM recommendations make sense from a variety of perspectives.
- Surfactant stabilised micronuclei may or may not prove to be a key player in human decompression sickness, but regardless the pioneering work of Kunkle and Yount has greatly broadened our understanding of how bubbles form - their contribution should not be underestimated.

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